20 January 2026 : Review article
Complete Blood Count in Delayed Graft Function: A Narrative Review
Marlene Marisol Perales-Quintana
ABDEF 1, Edelmiro Perez Rodriguez AEF 2*, Allina P. Flores-Mendoza DE 2, Homero Arturo Zapata-Chavira DE 2
DOI: 10.12659/AOT.950702
Ann Transplant 2026; 31:e950702
Table 3 Complete blood count parameters and outcomes.
| Study | Design | Donor subtype | n sutdied recipients | Predictive statistics | Main finding |
|---|---|---|---|---|---|
| Molnar MZ et al | Retrospective | Deceased donor and living donor | 11,836 | OR 1.25 (95% CI 1.01–1.55; <0.05) in brain-death donor;OR 1.15 (95% CI 0.98–1.34; <0.05) in living donor | U-shaped association between pre-transplant hemoglobin and DGF; both low and high Hb linked to higher DGF risk |
| Moreira-Silva | Retrospective | Deceased donor | 206 | OR 0.252 (95% CI 0.159–0.041; p<0.001) | Low pre-transplant Hb independently associated with DGF |
| Chutipongtanate A et al | Retrospective | Deceased donor and living donors | 269 | OR 3.62 (95% CI 2.13–6.14; p<0.001) | Perioperative Hb drop >1.35 g/dL predicted poor early graft function and higher DGF risk |
| Song T et al | Retrospective | Living donor | 702 | HR 1.186 (95% CI 0.53–2.65; p>0.05) | Pre-transplant Hb <10 g/dL not associated with DGF in living donor transplants |
| Lukaszewski M et al | Retrospective | Deceased donor | 86 | p>0.05 | Hemodilution-related Hb changes showed no impact on DGF occurrence |
| Hogendorf P et al | Retrospective | Deceased donor | 135 | OR 0.331, (95% CI: 0.151–0.728; p=0.006)OR 2.653, (95% CI: 1.158–6.078; p=0.021) | Higher pre-transplant lymphocyte counts predicts early graft dysfunctionLow preoperative lnNLR predicts early graft dysfunction |
| Pilichowska et al | Retrospectiva | Brain death donors | 365 | Pre – AUC=0.566, p=0.034; cut-off=0.71 G/LPost 24 h – AUC=0.623, p<0.001; cut-off=0.21 G/LPre (p=0.431);Post 24 h day 1 (p=0.912) | DGF had higher monocyte counts in pre- and 24-hour post-transplant blood samplesRecipient NLR not predictive of DGF development |
| Baral et al | Retrospective | Deceased donors | 289 | OR 13.48 (95% CI: 4.79–37.99; p<0.001) | Post-transplant NLR >3.5 increased DGF risk. |
| Halazun KJ et al | Retrospective | Deceased donor and living donor | 398 | H=10.673, (CI=6.151–18.518, p<.0001) | Early post-transplant NLR >3.5 predicts high DGF risk, especially in living-donor grafts |
| Cankaya E et al | Retrospective | Not specified | 137 | p=0.01 (lower NLR in preemptive vs non-preemptive at 1 year) | Preemptive kidney recipients showed lower NLR at 1 year |
| Zhang et al | Retrospective | Deceased donor | 199 | OR 2.8 (95% CI: 1.2–6.6; p=0.018) | Dynamic donor NLR change associated with higher DGF occurrence in recipients |
| Pilichowska et al | Retrospectiva | Deceased donor | 365 | P>0.5 | No predictive value for platelet count or platelet ratios |
| Baral et al | Retrospective | Deceased donors | 289 | HR 3.163 (95% CI 1.256–7.963; p=0.015). AUC 0.655; sensitivity 72.7%, specificity 58.2% | Higher pre-transplant PLR independently predicted DGF |
| Siddiqui et al | Retrospective | Deceased donor and living donors | 51 | AUC 0.69; sensitivity 68.8%, specificity 31.4% | Lower PLR associated with DGF in pediatric recipients |